SWISS HEALTH CARE THRIVES WITHOUT PUBLIC OPTION

October 2, 2009

Like every other country in Europe, Switzerland guarantees health care for all its citizens. But the system does not remotely resemble the model of bureaucratic, socialized medicine often cited by opponents of universal coverage in the United States. Swiss private insurers are required to offer coverage to all citizens, regardless of age or medical history. And those people, in turn, are obligated to buy health insurance. That is why many academics who have studied the Swiss health care system have pointed to this Alpine nation of about 7.5 million as a model that delivers much of what Washington is aiming to accomplish -- without the contentious option of a government-run health insurance plan.

As a potential model for the United States, the Swiss health care system involves some important trade-offs that American consumers, insurers and health care providers might find hard to swallow, says the New York Times:

The Swiss government does not ration care, but it does keep down overall spending by regulating drug prices and fees for lab tests and medical devices.

It also requires patients to share some costs -- at a higher level than in the United States -- so they have an incentive to avoid unnecessary treatments.

And some doctors grumble that cost controls are making it harder these days for a physician to make a franc.

The Swiss government also provides direct cash subsidies to people if health insurance equals more than 8 percent of personal income, and about 35 to 40 percent of households get some form of subsidy.

In some cases, employers contribute part of the insurance premium, but, unlike in the United States, they do not receive a tax break for it (all the health care proposals in Congress would provide a subsidy to moderate-income Americans).

Unlike the United States, where the Medicare program for the elderly costs taxpayers about $500 billion a year, Switzerland has no special break for older Swiss people beyond the general subsidy.

"Switzerland's health care system is different from virtually every other country in the world," says Regina Herzlinger, a Harvard University Business School professor who has studied the Swiss approach extensively.

"What I like about it is that it's got universal coverage, it's customer driven, and there are no intermediaries shopping on people's behalf," she added. "And there's no waiting lists or rationing."